Dr Una Adderley, Lecturer in Community Nursing at the University of Leeds and Tissue Viability Society Trustee
The Guest study (2015) highlighted the financial burden of chronic wound care. What was particularly shocking was that over a third of the wounds were some form of leg ulcer and over half of these did not have a working diagnosis. It is impossible to safely treat a non-healing wound on the lower leg unless you know the underlying cause that explains why the wound is not healing as it should.
The results of the Guest study did not come as a big surprise to those working in the tissue viability world.Tissue viability specialists have long despaired that patients have to wait too long before they reach a clinician with the knowledge and skills to offer care that increases the chances of healing.For over 15 years we have known that a leg ulcer that is larger than 10cm2 and which has been present for more than six months will be more difficult to hea l(Margolis et al., 2000). So imagine my frustration when it took six months for a member of my own family to be referred for a leg ulcer assessment, even when I know that there are excellent leg ulcer services in the locality where they live!
Soon after the Guest paper was published, a group of us shared our exasperation at the current situation and resolved to do something about it. Problems with the lower leg are common and many factors need consideration if care is to be effective and acceptable.We rapidly came to the conclusion that the most urgent need was to provide an accessible and reliable source of information for patients and generalists.Too many patients, GPs, practice nurses and nurses working in other services are either unaware of the need for early, accurate care or do not have access to services that can provide the expert care needed.
We have formed a group of charities and not-for profit organisations to address this information need.On 26th April we launched the Legs Matter Campaign.The Legs Matter website covers a range of skin problems on the lower leg and explains what good care should look like.We hope you and your patients will find it helpful.
MARGOLIS, D. J., BERLIN, J. A. & STROM, B. L. 2000. Which venous leg ulcers will heal with limb compression bandages? The American Journal of Medicine, 109, 15-19.
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